Note: These resource covers insulin access in the United States only. These resources may be out of date and were last updated January 2026.
Barriers to access to insulin and other diabetes supplies can include unaffordable health care, institutional unresponsiveness, and major life transitions. Being unable to afford or access insulin or other required supplies is not the fault of any of us as individuals; rather it is the outcome of decades of intentional policies and practices by Big Pharma.
Insulin is only as good as it can get into your body at the right amount. Glucose self-monitoring supplies and injection supplies are also necessary supplies for diabetes care. Below are links to different assistance programs for glucose self-monitoring supplies and injection materials:
We know that producing most analogue insulins costs less than $10 a month and yet they can cost over $300 a vial. High prices have been driven by greed, not other factors. This is not your fault! You are not alone in navigating this needlessly complicated and inaccessible system.
Support programs differ on the level of cost-sharing assistance, quantity of insulin provided, and program duration. They are often found to be unusable for patients who need them. Many patients are ineligible to apply: most programs limit their eligibility to US residents, require that patients accessing savings cards and patient assistance programs have an annual household income of less than 400% of the federal poverty level and do not qualify for Medicaid or demonstrate that they were denied Medicaid if eligible, and that patients do not qualify for low-income subsidies if covered under Medicare Part D. Most copay card, savings programs, and patient assistance programs have maximum supply per fill, quantity limits, expiration dates, as well as costs to patients. Programs can also have thresholds of maximum savings and it is unclear if patients can re-enroll after program expiration. Because these programs are provided by private corporations, they can be canceled or changed at any time, or patients can be found ineligible for coverage.
Patient assistance programs do not have to be HIPAA compliant. LillyCares, NovoCare and Sanofi Patient Connection applications all have the applicant sign away their right to privacy. The applications state that the data they collect are not covered by federal and state privacy laws like HIPAA and may be used by the company in marketing and sales, or the data can be shared or sold with other drugs or other companies. While these data privacy concerns do not directly impact prices, they are important considerations to many patients who may choose to not use these programs, despite cost concerns. Note that Coupon consolidator GoodRx, for example, has sold medication and intimate details of users with 20 internet companies, and in their overstepping, was recently hit with a $1.5mil fine for allowing the data to be used for digital marketing purposes.
Coupons and savings cards can be used by manufacturers to ‘product hop’ patients to new drugs. Coupon and savings card programs can overcome cost barriers to increase newer insulin access and use for patients in the short-term, building brand-name loyalty. They can be used by those with commercial insurance plans (and those without insurance) to move patients to newer, more expensive drugs by covering the initial costs, a practice called ‘product hopping’. Coupons have been found to increase the purchase of name-brand drugs over generics by over 60%. These programs have been estimated to increase the cost of prescription drugs up to $32 billion.
Copay assistance programs, through copay cards or coupons, reduce the amount that patients pay out of pocket through their insurance plans each month. Big Pharma gets tax breaks, increased sales, raised revenue and positive public relations when they give coupons for lowered product costs to those who can’t afford it through these programs, making it a win-win for them – one study showed that for every $1 invested in these programs, the donor company can garner up to $21 back.
Big Pharma makes donations to third party patient assistance programs which are often viewed as “investments'' for future returns. One example is Sanofi’s program, as exposed in the Dec 2021 Drug Pricing Investigation staff report. Exposed emails from Sanofi show that while Sanofi expected the patient assistance program program to reduce net sales for Lantus, the impact would lead to an expected increase in sales volume, and led to a three-fold increase in Lantus use. Sanofi also launched a patient affordability program to mitigate the negative media around price increases.
These third parties may terminate or modify their patient assistance programs at any time, including changing eligibility criteria and level of assistance. That’s why T1International supports structural reforms to lower insulin prices and to enhance transparency and accountability of manufacturer-funded patient assistance programs, including through public pharmaceutical manufacturing and distribution. The programs tied to insulin manufacturers listed below may be arduous or difficult to qualify for, but can be worth checking out if in need.
Finally, all but one follow-on and generic are all manufactured by the Big Three and, for that reason, do not offer significant cost savings to patients or payers. The two follow-on insulin formulations are Basaglar, a Lilly follow-on of Sanofi’s Lantus introduced in 2015, and Admelog, a Sanofi follow-on of Lilly’s Humalog introduced in 2018. “Authorized generic” insulins are not true generics in the pro-competitive sense that patients normally think of; they are instead exact copies of the brand-name products made and sold by the same companies that make the brand-name products. These include Lilly’s Lispro (a copy of Humalog) and Novo Nordisk’s aspart (a copy of NovoLog). Authorized generics are not widely available in pharmacies (only ~17%); the Big Three keep supplies low to keep patients on their higher-priced brand-name products.